Assessment of the diagnostic performance and interobserver variability of endocytoscopy in Barrett's esophagus:A pilot ex-vivo study  

作　　者：Yutaka Tomizawa Prasad G Iyer Louis M Wongkeesong Navtej S Buttar Lori S Lutzke Tsung-Teh Wu Kenneth K Wang 

机构地区：[1]Barrett’s Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic Rochester [2]Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester

出　　处：《World Journal of Gastroenterology》2013年第46期8652-8658,共7页世界胃肠病学杂志（英文版）

摘　　要：AIM: To investigate a classification of endocytoscopy (ECS) images in Barrett’s esophagus (BE) and evaluate its diagnostic performance and interobserver variability.AIM:To investigate a classification of endocytoscopy(ECS)images in Barrett’s esophagus(BE)and evaluate its diagnostic performance and interobserver variability.METHODS:ECS was applied to surveillance endoscopic mucosal resection(EMR)specimens of BE ex-vivo.The mucosal surface of specimen was stained with 1%methylene blue and surveyed with a catheter-type endocytoscope.We selected still images that were most representative of the endoscopically suspect lesion and matched with the final histopathological diagnosis to accomplish accurate correlation.The diagnostic performance and inter-observer variability of the new classification scheme were assessed in a blinded fashion by physicians with expertise in both BE and ECS and inexperienced physicians with no prior exposure to ECS.RESULTS:Three staff physicians and 22 gastroenterology fellows classified eight randomly assigned unknown still ECS pictures(two images per each classification)into one of four histopathologic categories as follows:(1)BEC1-squamous epithelium;(2)BEC2-BE without dysplasia;(3)BEC3-BE with dysplasia;and(4)BEC4-esophageal adenocarcinoma(EAC)in BE.Accuracy of diagnosis in staff physicians and clinical fellows were,respectively,100%and 99.4%for BEC1,95.8%and83.0%for BEC2,91.7%and 83.0%for BEC3,and95.8%and 98.3%for BEC4.Interobserver agreement of the faculty physicians and fellows in classifying each category were 0.932 and 0.897,respectively.CONCLUSION:This is the first study to investigate classification system of ECS in BE.This ex-vivo pilot study demonstrated acceptable diagnostic accuracy and excellent interobserver agreement.

关 键 词：Endocytoscopy  Barrett’ s esophagus  Dysplasia  Esophageal adenocarcinoma  Interobserver agreement 

分 类 号：R735.1[医药卫生—肿瘤] R571[医药卫生—临床医学]